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Organization

ELITE ANESTHESIA, P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL ALLEN MAHLER CRNA (PRESIDENT)
(704) 701-0851
Entity
Organization

Contact information

Practice address
1070 VINEHAVEN DR NE, DEPT OF ANESTHESIA, CONCORD, NC 28025-2438
(704) 783-1840
Mailing address
PO BOX 8846, GREENSBORO, NC 27419-0846
(336) 553-1659
(336) 553-3994

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
021MY
BCBS
NC
05
8000368
NC
Enumeration date
07/29/2008
Last updated
05/04/2011
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